Hopefully, it is apparent from this blog that I really do love my job and feel lucky to be a part of such a wonderful profession. Can you hear it coming – BUT… Today, I am on call. Actually, I don’t really mind being on call. The department where I work is quite lucky on call. When we are called in it is usually for a true emergency and nobody minds working late or in the middle of the night for a true emergency. Recently, I have been very lucky on call (knock on wood) and have slept the whole night at home in my own bed!

However, one thing that drives me crazy about being on call is well…the calls!!! The phone calls, pages, and “drop ins” to talk to me in the OR. They start when I arrive in the morning – around 7:15am. We do 24 hour call shifts, which means we do a regular list of elective surgeries during the day and then stay to finish up the cases in operating rooms that are running late, and then finally to do any emergencies or urgent cases that have come up.

So I arrive in the morning to set up for my elective list – today a wonderful day of urological procedures on a bunch of little ones with one of my favourite surgeons. My pager goes off: it is a neurosurgeon wondering why his patient who needs a new ventriculo-peritoneal (VP) shunt RIGHT NOW is not being done right at 8am like he thought! {An aside: a VP shunt is a tube inserted into the ventricles of the brain, where the cerebrospinal fluid (CSF) is made, and then tunnelled into the abdominal cavity. Patients who have blockages of their fluid or hydrocephalus have these put in to drain the fuild and lower the pressure on the brains.} So yes, a very important procedure. I go out to the OR desk to try and sort this out, because I have NO IDEA what he is talking about! We get it all sorted out, make a plan for his case to be done at 10:30 and I go back to my OR. I manage to get my case started, receiving 2 pages and one call into the OR just in the time it takes to get the patient off to sleep.

Next problem: the little baby who needs an urgent hernia repair also has a very significant heart problem AND is an ex-premature baby (so NOT straightforward). I then call the cardiologist, only to be interrupted by the Chief of surgery who tells me the ICU is over capacity and has no beds available.

Back to baby hernia: after speaking with cardiology it becomes apparent that this little baby definitely needs to go to ICU after anesthesia. Awesome. Then I hear from the neurosurgeon that my colleague says she knows nothing about the VP shunt and is not doing the case until someone tells her. That someone is supposed to be ME, but I haven’t had a chance due to the fact that I am trying to take care of my own patient AND answer all these calls. I get neurosurgery sorted AGAIN and go back to the baby hernia ICU problem.

I call the ICU to find out there is no possibility of a bed today and probably not tomorrow. Then I call the surgeon to discuss the medical necessity of fixing this hernia today. First bit of good luck of the day: she says it is no problem – baby hernia can wait as long as baby stays in the hospital so she can push the hernia back in, if it were to happen again.

By now it is only 9 am and I have been at work for a mere 1.5 hours – only 22.5 left to go.

Anyway, as you can tell, because I am typing this from the comfort of my own home at 10pm the day turned out well. VP shunt inserted in a timely fashion, baby hernia put off for a couple of days, OR cases finished by 6pm. But I hate the ‘calls’ during my on-call day, because I hate trying to multitask patient care. That is one reason why I chose anesthesia: to be able to focus on one patient at a time. And inevitably, I get cranky, usually after the 6th or 7th call in a row. I end up saying something like “I just need to focus on THIS patient RIGHT here! I will deal with you all AFTER!”.

Let me tell you, that doesn’t make anyone happy. Well, except for maybe the surgeon whose patient I am currently responsible for. Wish me luck that tonight is another ‘sleep at home” night. Good night all!

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